Category: Nevin Manimala

J Psychosoc Nurs Ment Health Serv. 2023 May;61(5):11-16. doi: 10.3928/02793695-20230417-03. Epub 2023 May 1.

ABSTRACT

Anxiety disorders are among the most common mental health conditions affecting pediatric populations. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, recommends objective measurement of pediatric anxiety for evaluation of symptomatology and treatment response. The objective of the current review was to summarize recommendations and resources for measuring pediatric anxiety, and to quantify and characterize use of outcome measures for generalized anxiety in pediatric psychiatry. These findings represent an essential step toward understanding how and to what extent anxiety rating scales are used in pediatric psychiatry and where quality improvement initiatives may be needed. Education, training, and further research are warranted to optimize use of measurement-based care for generalized anxiety in pediatric psychiatry settings and to determine which scales are optimal for use in this context. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 11-16.].

PMID:37129880 | DOI:10.3928/02793695-20230417-03

Drugs Aging. 2023 May 2. doi: 10.1007/s40266-023-01024-6. Online ahead of print.

ABSTRACT

BACKGROUND: The aging of our societies leads to a higher prevalence of multimorbidity and therefore polypharmacy, which often results in inappropriate drug treatment. To address this issue, numerous listing approaches, such as the Fit fOR The Aged (FORTA) list have been developed. FORTA’s positive impact on the quality of medications and relevant clinical outcomes has been shown. Based on new emerging evidence and experiences with the existing FORTA lists, we aimed to update the FORTA lists in several European countries/regions.

METHODS: Two-step Delphi consensus procedures were conducted in Poland, UK/Ireland, Italy, Spain, the Nordic countries, The Netherlands and France. The existing European FORTA lists served as survey proposals.

RESULTS: Thirty-two experts agreed to take part in this study (return rate: 96.9%). The country/region-specific overall consensus for all items and participants after the first round was > 90%. FORTA lists from six participating countries, plus the FORTA list for the German-speaking countries, were collated into the new EURO-FORTA List, which now contains 267 items aligned to 27 indications. Three items were added to the EURO-FORTA List, and no drugs were deleted. Eight FORTA items were relabeled, and 96.9% of the labels remained unchanged.

CONCLUSION: In this study, seven new country/region specific FORTA lists, as well as a new overarching EURO-FORTA List, were developed. An overall increase in the mean consensus coefficient and increases for all disease-specific mean consensus coefficients show a wider consensus among participants. The new lists have the potential to improve drug therapy in older people internationally.

PMID:37129833 | DOI:10.1007/s40266-023-01024-6

Curr Gastroenterol Rep. 2023 May 2. doi: 10.1007/s11894-023-00872-x. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Artificial intelligence (AI) is a rapidly growing field in gastrointestinal endoscopy, and its potential applications are virtually endless, with studies demonstrating use of AI for early gastric cancer, inflammatory bowel disease, Barrett’s esophagus, capsule endoscopy, as well as other areas in gastroenterology. Much of the early studies and applications of AI in gastroenterology have revolved around colonoscopy, particularly with regards to real-time polyp detection and characterization. This review will cover much of the existing data on computer-aided detection (CADe), computer-aided diagnosis (CADx), and briefly discuss some other interesting applications of AI for colonoscopy, while also considering some of the challenges and limitations that exist around the use of AI for colonoscopy.

RECENT FINDINGS: Multiple randomized controlled trials have now been published which show a statistically significant improvement when using AI to improve adenoma detection and reduce adenoma miss rates during colonoscopy. There is also a growing pool of literature showing that AI can be helpful for characterizing/diagnosing colorectal polyps in real time. AI has also shown promise in other areas of colonoscopy, including polyp sizing and automated measurement and monitoring of quality metrics during colonoscopy. AI is a promising tool that has the ability to shape the future of gastrointestinal endoscopy, with much of the early data showing significant benefits to use of AI during colonoscopy. However, there remain several challenges that may delay or hamper the widespread use of AI in the field.

PMID:37129831 | DOI:10.1007/s11894-023-00872-x

Pharmacoeconomics. 2023 May 2. doi: 10.1007/s40273-023-01264-9. Online ahead of print.

ABSTRACT

BACKGROUND: Quality-adjusted life expectancy (QALE) combines mortality risk and multidimensional health-related quality of life (HRQoL) information to measure healthy life expectancy in terms of quality-adjusted life years (QALYs). This paper estimates the relative importance of individual quality of life dimensions in explaining inequalities in QALE.

METHODS: We combined EQ-5D-5L data from the Health Survey for England for 2017 and 2018 (N = 14,412) with full population mortality data from the Office for National Statistics to calculate QALE by age, sex and deprivation quintile. The effect of HRQoL dimensions on the socioeconomic gradient in QALE was decomposed using an iterative imputation approach, in which inequalities associated with socioeconomic status in each domain were removed by imputing the response distribution of the richest quintile for all participants. Sampling uncertainty in the HRQoL data was evaluated using bootstrapping.

RESULTS: People in the least deprived fifth of neighbourhoods in England can expect to live 7.0 years longer and experience 11.1 more QALYs than those in the most deprived fifth. Inequalities in HRQoL accounted for 28.0% and 45.7% of QALE inequalities for males and females, respectively. Pain/discomfort, anxiety/depression and mobility were the most influential HRQoL domains.

DISCUSSION: Our results identify the extent of inequalities associated with socioeconomic status in lifetime health and the relative importance of inequalities by mortality and HRQoL. The contributions of the individual dimensions of HRQoL towards lifetime inequalities vary substantially by sex. Our findings can help to identify the types of interventions most likely to alleviate health inequalities, which may be different for males and females.

PMID:37129775 | DOI:10.1007/s40273-023-01264-9

Appl Biochem Biotechnol. 2023 May 2. doi: 10.1007/s12010-023-04502-0. Online ahead of print.

ABSTRACT

Production of value-added products from waste anaerobic digestate is economically and environmentally important for sustainable development of industrial process and products. In this study halophilic microalgae, Chlorella vulgaris 92001, Chlorella vulgaris 50291, Chlorella vulgaris 10241 and Tetraselmis indica, were initially screened for lutein production using synthetic dairy digestate (DD), municipal digestate (MD) and poultry digestate (PD) as no-cost substrates. Screening and optimization of parameters, such as dilution, pH, MgCl₂, NaCl, NaHCO₃ and inoculum concentration for maximum lutein production were further performed employing statistically designed Plackett-Burman and response surface methodology. Cultivation of C. vulgaris 92001 in a split column photobioreactor under optimum culture condition showed increase in lutein production by 2.36-fold in batch mode. The influence of different hydraulic retention time (HRT) values of 150, 130, 100 and 90 h on lutein production was evaluated in continuous mode with the split column photobioreactor. Lutein produced using the synthetic poultry digestate showed good potential biopesticide activity against Spodoptera litura (fall armyworm). Overall, this study demonstrated bioprocess development to produce lutein using synthetic anaerobic digestate from marine algae and its potential application as a biopesticide.

PMID:37129741 | DOI:10.1007/s12010-023-04502-0

Hepatol Int. 2023 May 2. doi: 10.1007/s12072-023-10535-8. Online ahead of print.

ABSTRACT

BACKGROUND: The level of C‑reactive protein (CRP) and alpha‑fetoprotein (AFP) in immunotherapy (CRAFITY) score was associated with the prognosis of hepatocellular carcinoma (HCC) patients treated with immunotherapy. Based on the CRAFITY score, this study aimed to investigate the efficacy and safety of locoregional-immunotherapy for treating HCC patients.

METHODS: HCC patients who received locoregional-immunotherapy were consecutively recruited at Sun Yat-sen University Cancer Center in 2019. CRAFITY 0 score was defined as the AFP level below 100 ng/ml and a CRP level of less than 1 mg/dl, CRAFITY 1 score was defined as the AFP level of at least 100 ng/ml or the CRP level of at least 1 mg/dl, and CRAFITY 2 score was defined as both the AFP level over 100 ng/ml and the CRP level of more than 1 mg/dl. The primary outcomes were progression-free survival (PFS) and overall survival (OS). The second outcomes were tumor response rate and treatment-related adverse events (AEs).

RESULTS: The median PFS for HCC patients with the CRAFITY 0 score was not estimable. The PFS was 11.0 months [95% confidence interval (CI) 7.2-14.9] and 6.0 months (95% CI 4.2-7.8) for patients with CRAFITY 1 and 2 scores, respectively, with a significant difference between the two groups (p < 0.001). HCC patients with CRAFITY 0, 1, and 2 scores had 3 years OS rates of 63.8%, 60.8%, and 32.1%, respectively, with statistical differences among the three groups (p < 0.001). Patients with the CRAFITY 2 score were more likely to experience fever than those with other scores (p < 0.05). A greater CRAFITY score was correlated with a higher incidence of grade 3 and above liver injury (p < 0.01).

CONCLUSIONS: The CRAFITY score is a superior predictor of prognosis and treatment-related AEs in HCC patients treated with locoregional-immunotherapy.

PMID:37129721 | DOI:10.1007/s12072-023-10535-8

Amino Acids. 2023 May 2. doi: 10.1007/s00726-023-03268-3. Online ahead of print.

ABSTRACT

Recent studies have shown that consuming amino acid-rich compounds improves tendon collagen content and biomechanical properties. Yet, it is unclear if the consumption of amino acids alters local (peritendinous) amino acid concentrations. If aging or exercise influence local amino acid concentrations in conjunction with an amino acid bolus is also not known. We conducted two studies. In Study 1, young women (n = 7, 25 ± 2 years) completed two identical resistance training sessions with either essential amino acid (EAA) or placebo consumption. In Study 2, an EAA bolus identical to Study 1 was given to younger (n = 7; 27 ± 1 year) and older adults (n = 6; 68 ± 2 years). Microdialysis was used to determine Achilles peritendinous amino acid and pro-collagen Iα1 (a marker of collagen synthesis) concentrations. In Study 1, amino acid consumption increased peritendinous concentrations of all EAA except histidine (p < 0.05). In Study 2, the peritendinous concentration of EAAs except for methionine, histidine, and lysine (p > 0.05) increased with time (p < 0.05). Further, the concentrations of most measured amino acids were greater in older adults (p < 0.05). Pro-collagen Iα1 concentration (p > 0.05) was unaffected by exercise, EAA, or aging (p > 0.05). Our findings demonstrate the following: (1) when not combined with exercise, an oral EAA bolus leads to only modest increases in Achilles peritendinous amino acid concentrations; (2) when combined with resistance exercise, EAA consumption resulted in greater peritendinous amino acid concentrations compared to no exercise; (3) the basal concentrations of most amino acids were greater in older adults, and (4) neither the EAA bolus nor exercise altered peritendinous pro-collagen concentrations.

PMID:37129720 | DOI:10.1007/s00726-023-03268-3

J Med Syst. 2023 May 2;47(1):55. doi: 10.1007/s10916-023-01945-0.

ABSTRACT

Hospital face increased resource constraints and competition. This escalates the need for efficiency optimization especially in resource-intense areas, such as the Operating Room (OR). Efficiency cannot happen at expenses of patient outcomes. Innovative digital support systems (DSS) have been introduced into the market to support established standardization methods of intraoperative workflows further. This review aimed to analyze whether applied standardization methods and implemented DSS of intraoperative surgical workflows lead to increasing efficiency and demonstrate economic improvements. A systematic review of intraoperative surgical workflows standardization and digitalization was performed. Journal articles and reviews from 2000 to 2023 were retrieved from EBSCO, PubMed, and Scopus databases, as well as the internal database of Johnson & Johnson. 17 articles showed a significant increase in efficiency through standardization, which led to cost reductions between $70.20 to $3,516 per case without negatively impacting quality. Five additional articles on DSS demonstrated a significant positive impact on efficiency and quality. Reduction in OR-time between 6 to 22% per case was one main contributor. No literature on DSS revealed any correlated economic impact. Selected standardization methods and introduced DSS for intraoperative surgical workflows effectively increase efficiency while maintaining or even improving quality. Demonstrated cost-effectiveness of non-digital standardization methods across surgical areas requires more research on complex and resource-intensive procedures and the economic value of DSS to support hospital management’s strategic decisions to overcome the increasing economic burden.

PMID:37129717 | DOI:10.1007/s10916-023-01945-0

Arch Osteoporos. 2023 May 2;18(1):59. doi: 10.1007/s11657-023-01246-6.

ABSTRACT

The prevalence of glucocorticosteroid-induced osteoporosis (GIOP) is well established in higher income countries. There are limited studies showing a wide prevalence of GIOP in Africa. Prospective studies are needed on GIOP in African rheumatology patients to implement appropriate management algorithms.

PURPOSE: The prevalence of glucocorticosteroid-induced osteoporosis (GIOP) is well established in developed countries, but little is known about GIOP in African adult patients with inflammatory rheumatic musculoskeletal diseases (RMDs). This study aimed to determine the prevalence of GIOP and osteoporotic fracture risk in African patients with inflammatory RMDs according to radiographic and bone mineral density (BMD) findings.

METHODS: PubMed, Google Scholar, Scopus, and African Index Medicus were searched up to 31 December 2020. Heterogeneity was assessed using I² statistic across the included studies. A random-effects model was applied to estimate the pooled effect size across studies. All statistical analyses were performed using STATA™ version 14 software. The study was registered with PROSPERO, number CRD42021256252.

RESULTS: In this meta-analysis, a total of 7 studies with 780 participants, stratified by geographical region were included. The pooled prevalence of GIOP based on BMD data was 47.7% (95% CI 32.9-62.8) with 52.2% (95% CI 36.5-67.6) in North African countries and 15.4% (95% 1.9-45.4%) in South Africa with a high heterogeneity (I² = 93.3%, p = 0.018). There was no data from the rest of African countries. We were unable to complete the meta-analysis of osteoporotic fractures due to the lack of available data.

CONCLUSION: This study revealed that the prevalence of GIOP varies significantly in Africa. There is no information, however, for most of Africa, and further prospective studies are needed to develop context-specific GIOP preventive strategies in patients with RMDs.

PMID:37129714 | DOI:10.1007/s11657-023-01246-6

J Acoust Soc Am. 2023 May 1;153(5):2690. doi: 10.1121/10.0017888.

ABSTRACT

Localization and tracking of marine animals can reveal key insights into their behaviors underwater that would otherwise remain unexplored. A promising nonintrusive approach to obtaining location information of marine animals is to process their bioacoustic signals, which are passively recorded using multiple hydrophones. In this paper, a data processing chain that automatically detects and tracks multiple odontocetes (toothed whales) in three dimensions (3-D) from their echolocation clicks recorded with volumetric hydrophone arrays is proposed. First, the time-difference-of-arrival (TDOA) measurements are extracted with a generalized cross-correlation that whitens the received acoustic signals based on the instrument noise statistics. Subsequently, odontocetes are tracked in the TDOA domain using a graph-based multi-target tracking (MTT) method to reject false TDOA measurements and close gaps of missed detections. The resulting TDOA estimates are then used by another graph-based MTT stage that estimates odontocete tracks in 3-D. The tracking capability of the proposed data processing chain is demonstrated on real acoustic data provided by two volumetric hydrophone arrays that recorded echolocation clicks from Cuvier’s beaked whales (Ziphius cavirostris). Simulation results show that the presented MTT method using 3-D can outperform an existing approach that relies on manual annotation.

PMID:37129673 | DOI:10.1121/10.0017888